JCPSLP Vol 15 No 2 2013

Clinical education

Reflective practice What is it and how do I do it? Abigail Lewis

experiences in order to lead to a new understanding and appreciation” (Boud et al., 1985, p. 19). Reflection involves a number of skills (such as observation, self-awareness, critical thinking, self-evaluation and taking others’ perspectives) and has the outcome of integrating this understanding into future planning and goal setting (Mann, Gordon & MacLeod, 2009). Reflection may occur at different times. Schön (1987) describes two occasions of reflection: reflection-in-action (occurring simultaneously during an experience) and reflection-on-action (occurring after an experience). Boud (2001) adds to this list reflection-in-anticipation, where a practitioner would reflect in order to make a thorough preparation for a future experience. There are different models of reflection described in the literature which are usually iterative (a particular experience triggers reflection and results in a new understanding or decision to act differently in the future) or vertical (describing depth of reflection from a surface level to a deeper critical synthesis level resulting in changes in behaviour) (see Mann et al., 2009 for a full description). Boud and colleagues’ comprehensive model of reflection includes both dimensions (Boud et al., 1985) and this has led to its wide use in a number of fields (for example, Chirema, 2007; Wong, Kember, Chung & Yan, 1998) including in speech pathology (Lincoln et al., 1997). In Boud and colleague’s model, the practitioner: • returns to a situation or event (e.g., spends time thinking about a prior interaction with a client, response to a workshop or strong reaction to a colleague); • attends to their feelings about the experience; • re-evaluates in light of their previous experiences (so making meaning); and • has an outcome or resolution for the situation. The indicators of depth of reflection are: making associations with previous experiences, knowledge or feelings; integrating the new information with current knowledge; validating the new information; changing future behaviour (appropriation); and finally, setting an outcome for the future (Boud et al., 1985). Why is RP an important skill for speech pathologists? The focus on developing RP has increased across teaching, nursing, medicine and allied health professions in the last twenty-five years (Mann et al., 2009). In this time the workplace has become more complex and RP is seen as a

Keywords competence expertise reflection reflective practice tools for reflection

An unexamined life is not worth living. Socrates

Reflective practice holds importance for health and education practitioners in Australia, as demonstrated by increased prominence in the revised Competency- based Occupational Standards for speech pathologists. This paper explores the topic of reflective practice, in the clinical context, by addressing the following questions: What is reflective practice? Why is it an important skill for speech pathologists? What is the evidence base for reflective practice? How do practitioners and students engage in the process of reflection? In addressing the final question, four methods of facilitating reflection are outlined: journal reflection, reflection on a critical incident, reflection following professional development, and reflection on a clinical encounter. A s early as the 1930s, the educator Dewey stated “there can be no true growth by mere experience alone, but only by reflecting on experience” (cited by Lincoln, Stockhausen & Maloney, 1997, p. 100). However, it was not until the 1980s that reflective practice (RP) started to be widely discussed, following the publication of Schön’s seminal books (Schön, 1983; 1987) and Boud and colleagues’ widely used model of reflection, described below (Boud, Keogh & Walker, 1985). There is now a growing body of literature supporting the importance of RP across a number of fields although there is only limited research in speech pathology (for example see Freeman, 2001; Geller & Foley, 2009; Hill, Davidson, & Theodoros, 2012). This paper aims to describe the evidence base and the importance of RP for speech pathologists, as well as to describe four different ways that students and practitioners can facilitate their own reflection throughout their lifelong learning journey. What is reflective practice? RP is “a generic term for those intellectual and affective activities in which individuals engage to explore their

This article has been peer- reviewed

Abigail Lewis

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JCPSLP Volume 15, Number 2 2013

Journal of Clinical Practice in Speech-Language Pathology